观察左卡尼汀联合促红细胞生成素治疗肾性贫血的疗效

目的观察左卡尼汀对重组人红细胞生成素（r—HuEPO）治疗肾性贫血疗效及不良反应,以探讨其临床价值。方法将36例维持性血液透析患者随机分为治疗组和对照组,每组18例,2组同时于血透后每周给予r-HuEPO100—150U／kg皮下注射,待血红蛋白（Hb）≥110g／L,红细胞压积（Hct）≥30％后减量,维持Hct在30％-35％;治疗组另于每次血透后静脉注射左卡尼汀2．0g,共12周。结果2组患者的Hb、Hct较治疗前明显升高,治疗组优于对照组（P〈0．05）;治疗组红细胞生成素的每周平均用量较对照组少,2组比较差异有统计学意义（P〈0．05）。结论左卡尼汀能显著提高促红细胞生成素治疗肾性贫血的疗效,减少促红细胞生成素的用量,降低不良反应发生率。     

Characterization and Phylogenetic Analysis of Brazilian Chicken Anaemia Virus

Chicken anaemia virus (CAV) was detected by a Nested-PCR assay in field samples from different regions of Brazil. The 539 bp amplified fragments of vp1 gene from 44 field samples were sequenced and 10 new nucleotide sequences of CAV were observed. These sequences were phylogenetically analysed by Mega2 using neighbour joining distance methods with 1000 bootstrap replications. Phylogenetic analysis did not show correlation between CAV pathology pattern and genetic groups. The 10 nucleotide sequences of the Brazilian samples were also analysed together with 30 sequences of CAV strains previously described from other countries. The genetic variability observed was not related to the geographical distribution. Amino acid substitutions were detected at 9 positions of the Brazilian sequences and two of them had not been observed before, ⁶⁵R replacing the Q residue and ⁹⁸F replacing Y residue. The nucleotide sequence data reported in this paper have been submitted to the GenBank nucleotide sequence database and have been assigned the accession numbers AY855079 to AY855088.     

Targeted disruption of FANCC and FANCG in human cancer provides a preclinical model for specific therapeutic options

BACKGROUND & AIMS: How specifically to treat pancreatic and other cancers harboring Fanconi anemia gene mutations has raised great interest recently, yet preclinical studies have been hampered by the lack of well-controlled human cancer models. METHODS: We endogenously disrupted FANCC and FANCG in a human adenocarcinoma cell line and determined the impact of these genes on drug sensitivity, irradiation sensitivity, and genome maintenance. RESULTS: FANCC and FANCG disruption abrogated FANCD2 monoubiquitination, confirming an impaired Fanconi anemia pathway function. On treatment with DNA interstrand-cross-linking agents, FANCC and FANCG disruption caused increased clastogenic damage, G2/M arrest, and decreased proliferation. The extent of hypersensitivity varied among agents, with ratios of inhibitory concentration 50% ranging from 2-fold for oxaliplatin to 14-fold for melphalan, a drug infrequently used in solid tumors. No hypersensitivity was observed on gemcitabine, etoposide, 3-aminobenzamide, NU1025, or hydrogen peroxide. FANCC and FANCG disruption also resulted in increased clastogenic damage on irradiation, but only FANCG disruption caused a subsequent decrease in relative survival. Finally, FANCC and FANCG disruption increased spontaneous chromosomal breakage, supporting the role of these genes in genome maintenance and likely explaining why they are mutated in sporadic cancer. CONCLUSIONS: Our human cancer cell model provides optimal controls to elucidate fundamental biologic features of individual Fanconi anemia gene defects and facilitates preclinical studies of therapeutic options. The impact of Fanconi gene defects on drug and irradiation sensitivity renders these genes promising targets for a specific, genotype-based therapy for individual cancer patients, providing a strong rationale for clinical trials.     

High levels of neopterin and interleukin-3 in sickle cell disease patients

Sickle cell disease (SCD) is recognized as a chronic inflammatory condition. Cytokines are released in response to stress or pathological situations, and influence hematopoiesis. The aim of this study was to evaluate interleukin-3 (IL-3), interferon-gamma (IFN-gamma), and neopterin (NP) levels in steady-state patients with sickle cell anemia (SS) (n = 35) and SC hemoglobinopathy (n = 15) in order to verify the possible action of those cytokines and NP on iron metabolism and hematopoiesis. Serum IL-3 concentration was higher in SS and SC groups than in controls, whereas IFN-gamma levels did not differ among groups. SS patients presenting hemoglobin fetal (HbF) >or=8.5% had significantly higher IL-3 levels than those with HbF <8.5% (P = 0.0338). No correlation was observed among inflammatory and iron metabolism parameters. Significant correlations were observed between IL-3 and Hb levels (r = 0.4633, P = 0.0457), and IL-3 and HbF levels (r = 0.6011, P = 0.0065). A negative correlation was observed between IL-3 and reticulocyte counting (r = -0.4632, P = 0.0457) only in the SS group. NP levels were significantly higher in the SS and SC groups than in controls, but did not differ between SS and SC. No correlation was observed between NP and iron metabolism parameters. These data suggest that IL-3 stimulates hematopoiesis, and that SS patients, even in steady state, have macrophage/monocyte activation (represented by high levels of NP) that probably contributes to their chronic inflammatory condition.     

蔗糖铁注射液联合红细胞生成素治疗维持性血液透析患者肾性贫血的疗效与安全性

目的 比较静脉应用蔗糖铁与口服多糖铁复合物对使用红细胞生成素.的维持性血液透析患者的肾性贫血的疗效与安全性.方法 采用同期随机对照研究,将接受维持性m液透析肾性贫血患者42例,随机分为静脉组和口服组各21例,分别给予蔗糖铁静脉推注和口服铁剂治疗,比较2组患者贫血治疗的效果及不良反应发生情况.结果 治疗后,血红蛋白(Hb)、红细胞压积(HCT)、血清铁蛋白(SF)、血清转铁蛋白饱和度(TSAT)的升高,静脉组较口服组差异有统计学意义(P<0.05);静脉组不良反应少于口服组(P<0.05).结论 在伴有缺铁的维持性血液透析患者肾性贫血的治疗中,蔗糖铁升高Hb的作用较口服铁剂更快,且不良反应发生率更低.     

孕前孕期铁剂补充现状及其对孕产妇贫血的影响

目的了解孕产妇在孕前孕期铁剂补充现状及其对孕产妇贫血的影响。方法选取重庆市妊娠满37周的孕妇或者在助产机构住院分娩的处于产褥期的产妇,且孕期或者分娩后3~7d内做过至少1次及以上的血常规检查者作为研究对象,运用问卷调查和血液检测方法,了解其铁剂补充现状和贫血情况。结果共调查2 019名孕产妇,其中有32.19%的孕产妇在孕前孕期补充过铁剂,且频率以"每天1次"为主。91.54%的孕产妇铁剂补充是在医生指导下进行的。补充过铁剂的孕产妇贫血患病率低于未补充者。结论补充铁剂能有效预防孕产妇贫血,建议从孕前开始直至整个孕期,都应科学合理地补充铁剂,降低贫血的发生率。     

Renal dysfunction and anemia features in geriatric patients with chronic heart failure

Aim of the work was to study the features of renal dysfunction and anemia in the patients with chronic heart failure(CHF) and saved or disturbed left ventricular systolic function(LVSF).There were examined 47 geriatric men [mean age(64.3±0.8)] with CHR due to IHD and arterial hypertension.Evaluated the glomerular filtration rate(GFR),the presence of microalbuminuria(MAU),levels of serum creatinine,ferum,erythrocyte count.GFR lowered not only in patients with saved LVSF.Increased MAU and SK,Hb concentration lowering were evaluated in patients with LVSF disturbance.No correlation between Hb level and renal function was revealed.     

维生素A复合其他微量营养素对3～6岁儿童营养状况的影响

目的观察维生素A复合其他微量营养素对儿童营养状况的影响。方法采用分层与整群抽样相结合的方法,在重庆市近郊7所幼儿园中随机选取3所,将所有3～6岁、符合纳入标准的350名学龄前儿童作为受试对象。按分层随机的方法,将350名受试儿童随机分成单独补维生素A组(A组)、补维生素A加锌组(AZ组)及补维生素A与多种微量营养素复合物组(AMM组)。3组受试儿童同时连续补充6个月。干预前后分别测量儿童身高、体质量,计算儿童体格发育Z评分,评价儿童营养不良的发生率;检测血清维生素A、锌、铁、钙和血红蛋白水平;在营养素干预前采用问卷方式调查儿童的一般情况、家庭状况及饮食习惯等;在营养素干预期间采用24h膳食回顾法调查受试儿童膳食营养素摄取情况。结果 24h膳食回顾调查结果显示,该地区3～6岁儿童膳食中维生素A、锌和钙摄入不足。营养素干预6个月后,3组儿童血清锌和铁水平较干预前差异均有统计学意义(P均<0.01),AZ组血清锌水平的升高幅度高于AMM组(P<0.05)。AZ组及AMM组干预后血清维生素A水平分别升高了(0.05±0.23)μmol/L及(0.09±0.28)μmol/L(P<0.05,P<0.01);单独补充维生素A组血清维生素A水平升高了(0.03±0.27)μmol/L,但差异无统计学意义(P>0.05)。AMM组儿童血清维生素A水平升高幅度高于A组和AZ组(P均<0.05);AMM组儿童血红蛋白水平升高幅度高于A组(P<0.05)。A组、AZ组及AMM组中儿童营养不良的比例均有不同程度的下降,但3组间变化值差异均无统计学意义(P均>0.05)。结论复合多种微量营养素的补充对3～6岁儿童营养状况的作用较两种微量营养素的补充未见显著性差异,儿童微量营养素的补充应根据其存在的主要营养问题选择最优营养素组合,以改善儿童营养健康状况。